When a loved one experiences of loss of independence due to age or illness, family members often struggle to know what kind of nursing at home care is needed.  There are so many different types of services, home health care, private duty nursing, home care, companion care, caregivers, hospice, Medicare certified home health.  It’s no wonder that families are often confused and frustrated.  Here is what each kind of care means and who might need it. 

Home health care is a broad term that may involve just about any kind of medical services in the home, usually skilled nursing services, physical therapy, occupational or speech therapy.  Some non-medical care may be provided by a Certified Home Health aide. A person recently hospitalized may be discharged with a referral to home health care that is Medicare certified if the patient is over 65, or funded through traditional medical insurance.  A patient of Medicare home health must be considered homebound. This type of home health care involves visits, typically up to 45 minutes in length a few times a week for a short period of time.  All services are performed under orders from the patient’s doctor and fall into a plan of care.  A caregiver working a shift is not covered under Medicare certified home health. 

Home Care is a term that often applies to non-medical services in the home, those of a companion, caregiver, or personal care attendant, typically working shifts of three to 24 hours a day.  Home care is mostly regularly scheduled shift care to help with activities of daily living such as bathing, dressing, meal preparation, laundry and light housekeeping, errands, incidental transportation, and constant safety monitoring.  Caregiver are not allowed to administer medications or make medical recommendations.  Caregivers cannot dose insulin or morphine, but can only assisted clients with self-administration of medications. Homecare is not usually funded by regular insurance, but long term care insurance policies do cover it.  For those with limited income or assets, a Medi-Cal funded program known as IHSS may help.

Private duty nursing means nursing care that is not covered by insurance or Medicare, such as shift care in the home.  An RN or LVN may perform private duty nursing care, along with a home health aide.  A private duty nurse may be needed if a client needs help with a G-tube or J-tube, insulin injections, nurse care management, or extra nursing visits for someone who is not homebound. Private duty nurses can organize and fill pill boxes on an ongoing basis.  All private duty nursing is still ordered by a physician and follows a service plan or plan of care, but the person receiving private duty nursing does not need to be homebound.  

Hospice care is typically thought of as end of life care, and it’s appropriate when someone is expected to pass away within the following six months.  To qualify for hospice care a doctor’s order is needed, and it’s covered by Medicare and traditional health insurance.   In hospice, treatments to control symptoms can continue, but not treatments to “cure” a patient of a disease.  Hospice involves visits from an RN, Home Health Aide, physician, social worker or chaplain to the home, mostly to control pain and ease a person through the dying process.  It is generally not caregiving care nor 24 hour care. 

If a loved one is currently in the hospital or a rehabilitation center, a great resource is the discharge planner or the “nurse navigator”.   These skilled professionals have special training to help patients seek out the appropriate community resources.

At Home Nursing Care can also help.  We can provide an evaluation to determine the level of care that would be best for yourself or your family member.

If you or your loved one need non medical in home nursing care, call At Home Nursing Care at 760-634-8000 for quality Los Angeles and San Diego home health care.